Provider Demographics
NPI:1093963365
Name:KHOURY, MICHAEL NABIL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:NABIL
Last Name:KHOURY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1525 BUFORD HWY
Mailing Address - Street 2:
Mailing Address - City:BUFORD
Mailing Address - State:GA
Mailing Address - Zip Code:30518-3665
Mailing Address - Country:US
Mailing Address - Phone:470-325-1300
Mailing Address - Fax:470-325-1301
Practice Address - Street 1:1525 BUFORD HWY
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-3665
Practice Address - Country:US
Practice Address - Phone:470-325-1300
Practice Address - Fax:470-325-1301
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2042432084N0400X
GA0750812084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology